Roche CoaguChek XS Plus, Training Manual

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56 CoaguChek Professional Monitoring Systems
Training Manual
6
Training
The clinic will be managed by trained staff - designated users.
Personnel responsible for the clinic must be aware of professional accountability and undertake the
clinic management only if they feel competent to do so.
Accredited courses are available. Personnel managing the clinic will also be aware of continued
professional development and attend regular updates on anticoagulation management.
A patient group direction may be utilised in acute situations e.g. over anticoagulation, or where urgent
supply of warfarin to a patient is warranted.
If independent prescribing by nurses and pharmacists is to be undertaken their names must be
annotated on their professional registers to indicate successful completion of recognised prescribing
training.
Training should include:
•
An introduction to oral anticoagulation therapy, an understanding of
the test to be performed, the INR and how it is derived
•
An understanding of specific POC device for deriving INR, setting up
and using the device
•
The target INR, how it relates to diagnosis, action if results outside
limits
•
Management of VKA therapy based on INR results and
management of other anticoagulation therapy
•
Recording of results and quality assurance materials.
•
Health and safety - disposal of sharps, Control of Substances
Hazardous to Health (COSHH) regulations.
Standard operating procedures will be needed when using POC
devices
I
Identification & referral of patients
Referrals from other clinics or specialists.
For primary care - the practice computer database will identify most patients. In addition patients can
be identified from anticoagulation therapy prescriptions. Regular computer searches (every 3 months)
will check for new patients to the practice receiving anticoagulation.
Hospital/primary care anticoagulant clinics will need to be informed of all patients attending other
clinics. A letter should be sent to the hospital/primary care clinic to inform them if another clinic is
going to take over the anticoagulation monitoring. A referral letter should include clinical indication,
recommended period on anticoagulation and target INR. An example referral form is shown in
Appendix 1.
Telephone referrals cannot be accepted unless under exceptional circumstances.